FACILITY/SCHOOL
VACCINE CLINIC 

In conjunction with Facility/School, Eric's RX Shoppe is happy to partner to provide a vaccine clinic for ages 3+.  Details of the event are below:

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Date: Date/Time

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Where: Location Name - Address

 

Vaccine Offered:​​​

• Pfizer COVID-19 Variant Booster - Ages 12+​

  • Anyone who completed their primary series (Pfizer, Moderna, or J&J) can get a Pfizer-BioNTech COVID-19 Bivalent Booster. 

  • Must be 12+ years of age, and

  • Must be a minimum of 2 months from the completion of a primary series or last booster dose.

• Flu Shots - Ages 3+ (High Dose for ages 65+)

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Pre-registration is highly recommended.

• IF THIS IS FOR A PEDIATRIC DOSE, PLEASE REGISTER USING YOUR CHILD'S NAME, DOB, AND ALL OTHER INFORMATION!

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If you are under 18, you must have either a parent/guardian present or have the proper consent form(s) printed and signed (NO EXCEPTIONS).

• COVID BOOSTER MINOR CONSENT FORM​​

• FLU MINOR CONSENT FORM

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A page will appear titled Insurance Information. This is not a required section, but highly encouraged; however, if you do provide the information, it asks for your physician telephone #. Please do not include the dashes (-) between the numbers.

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Registration will close on 

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Any questions, please email us at covidvaccine@ericsrx.com or call us at 215-509-5597 X.2.